| ObjectiveTo investigate the effect of expanding midpalatal suture in adults by personalized miniscres-assised rapid palatal expander on condylar position.MethodsRetrospective study was taken,midpalatal suture of 10 adult patients with maxillary transverse deficiency were expanded using a personalized miniscrew-assisted rapid palatal expander.The related condylar position parameters of temple mandible joint were measured and contrasted before expansion(T0),after expansion(T1)and after retention for three months(T2)on CBCT.Pain scores of patients in different periods were recorded and compared.Statistical analysis was completed with the SPSS 21.0 software.Results1.The changes of temporomandibular joint space①Superior space(SS)of temporomandibular jointSuperior space(SS)of left temporomandibular joint were increased 0.31±0.24 mm compared T1 and T0 and right SS increased 0.54±0.41 mm,there were statistic significance on both sides(P<0.05);The SS of left temporomandibular joint became narrowed0.17±0.14 mm between T2 and T1,the changes of the space were significant statistically(P<0.05),the SS changes of right temporomandibular joint were not significant statistically(P>0.05);The SS of left temporomandibular joint were increased 0.15±0.15 mm between T2 and To while SS of right temporomandibular joint were increased 0.34±0.34 mm between T2 and To there were statistic significance on both sides(P<0.05).②Anterior space(AS)of temporomandibular jointThere was no statistic significance of the anterior space(AS)changes at temporomandibular joint on both sides between T1 and T0;The AS of right temporomandibular joint were increased 0.33±0.30 mm between T2 and T1 after retention for three months,the change amount of the space was significant statistically(P<0.05);There was no statistic significance of the changes for the anterior space(AS)of the left temporomandibular joint between T2and T1(P>0.05);There was no statistic significance of the changes for anterior space(AS)of temporomandibular joint on both sides between T2 and To after retention for three months(P>0.05).③The posterior space(PS)of temporomandibular jointThe posterior space(PS)of left temporomandibular joint was increased 0.77±1.01mm between T1 and T0,The PS of right temporomandibular joint was increased 0.49±0.46 mm,the changes of the space on both sides were significant statistically(P<0.05);There was no statistic significance of the PS changes at temporomandibular joints on both sides between T2 and T1(P>0.05)after retention for three months;There was no statistic significance of the PS changes at temporomandibular joint on left side between T2 and T0 while the posterior space(PS)of right temporomandibular join were increased 0.44±0.59 mm,the changes of the space were significant statistically(P<0.05).④The medial space(MS)of temporomandibular jointThe medial space(MS)of left temporomandibular joint were narrowed0.56±0.65mm between T1 and To and 0.49±0.29 mm on right side,there was statistic significance of the changes on both sides(P<0.05);There was no statistic significance of the MS change amounts at temporomandibular joint on left side between T2 and T1(P>0.05)and the medial space(MS)of right temporomandibular join was increased 0.22±0.30 mm,the changes of the space were significant statistically(P<0.05);There was no statistic significance of the MS changes at temporomandibular joint on left side between T2 and T0(P>0.05)and the MS changes on the right side were narrowed 0.27±0.24 mm and the changes of the space were significant statistically(P<0.05).⑤The lateral space(LS)of temporomandibular jointThe lateral space(LS)of left temporomandibular joint was increased 0.34±0.38 mm mm between T1 and T0 and 0.42±0.34 mm on right side,the changes of the space were significant statistically on both sides(P<0.05).There was no statistic significance of the LS change amounts at temporomandibular joint on both side between T2 and T1(P>0.05),the LS of left temporomandibular joint was increased 0.35±0.47 mm between T2 and T0 and 0.29±0.34 mm on right side,the change amount of the space was significant statistically on both sides(P<0.05).2.Changes of temple mandible joint radius and condyle horizontal angleThere were no significance changes of radius of temple mandible joint and horizontal angle of condyle statistically on both sides between T0,T1 and T2 statistically(P>0.05).3.Change of pain degreeVisual Analogue Scores were used to evaluate the pain during period of treatment,There was a mild discomfort on mandibular joint on both sides at the day of expander installation(T0),the VAS were decreased obviously at T1(P<0.05)and there was no pain at T2(after retention for three months).ConclusionsPersonalized miniscrew-assisted rapid expansion of palatal suture among adults can cause appropriate forward-down changes of the condyle position which is beneficial to the stability of correction effect and there was no obvious discomfort on patients. |
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